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A recent article in the Chicago Tribune will likely fuel concerns that nonprofit hospitals are getting tax breaks without providing enough charity care. Investigative reporters found evidence that a number of nonprofit hospitals in the Chicago area will stabilize patients who arrive at the ER but then send them to the Cook County's Stroger Hospital, the government-run hospital in Chicago. The result has been severe overcrowding at the county hospital and concerns about the costs transferred to the county along with the patients. Patients arrive at Stroger with discharge slips directing them to go to the county hospital. One man had a broken jaw, one had a tumor, and one discharge slip directed a woman to "Follow up at Cook County Hospital for uterine tumor surgery."

The hospitals contacted in connection with the story deny that they steer patients to Stroger and say that they are just trying to allocate care by "triaging out" patients who do not belong in an ER.

The article points out that the nonprofit hospitals spend only 2% of their revenue on charity care and for-profit hospitals spend 1% - without the benefit of the tax breaks the nonprofit hospitals are getting. Stroger is there as a safety net, but Stroger is funded with tax revenues and has suffered staff and service cuts recently. Overcrowding has become a huge concern at Stroger, and Stroger cannot simply "triage out" patients who have nowhere else to go.

This article provides additional information for the ongoing discussions in Illinois about the level of charity care that should be required for exempt status.